WASHINGTON, DC – Reps. Brian Fitzpatrick (PA-1), Jimmy Panetta (CA-19), John Joyce, M.D. (PA-13), and Paul Tonko (NY-20) introduced the bipartisan Radiation Oncology Case Rate (ROCR) Value-Based Program Act of 2024 that would modernize Medicare reimbursement for radiation therapy.  This legislation would safeguard access to high quality cancer treatments for patients nationwide, improve patient outcomes and reduce health disparities while generating savings for Medicare.

The Radiation Oncology Case Rate (ROCR) program shifts Medicare’s current per-treatment payment system to a more patient-centered approach. With substantial advances in cancer treatment, shorter courses of radiation therapy are increasingly recommended in evidence-based clinical guidelines, yet the outdated fee-for-service approach of Medicare’s current payment system penalizes radiation oncologists for following best practices in patient care.

“The ROCR Act is a crucial step toward reforming our health care system to better serve people with cancer,” said Congressman Fitzpatrick, co-chair of the House Cancer Caucus. “By introducing this bill, we are standing up for Americans who rely on radiation therapy as a lifeline during their most challenging times and ensuring they have access to state-of-the-art treatment through a fair and modernized payment system.”

“The current Medicare Part B payment system favors longer courses of cancer treatment and undermines the ability of radiation oncology clinics to provide tailored care,” said Congressman Panetta.  “By creating a bundled payment system with our bipartisan ROCR Act, we’ll more readily incentivize high-value treatment for patients and potentially reduce the frequency of radiation sessions.  We need to ensure that Medicare is providing the best care possible for beneficiaries while properly compensating providers in their work.”

“A cancer diagnosis is devastating for both a patient and their family, and no patient receiving this life-altering news should be told that some treatments are unavailable. Innovation is the bedrock of American medicine, and I’m proud to join this bipartisan group to introduce the Radiation Oncology Case Rate (ROCR) Act, which would help ensure that seniors have access to the innovative and curative therapies that they need,” said Congressman Joyce.

“I've long been a believer in the tremendous value that radiation therapy delivers for cancer patients and have worked for years to ensure fair and stable payment that supports access to high quality care,” said Congressman Tonko. “The ROCR Value-Based Care Act responds to the challenges facing our nation’s cancer clinics and patients with a sound policy solution that supports better outcomes and access across New York and America. I’m ready to work with my bipartisan colleagues and the radiation oncology community to pass the ROCR Act this Congress.”

“ASTRO applauds Sen. Tillis, Rep. Fitzpatrick, Rep. Panetta, Rep. Joyce and Rep. Tonko for their exemplary bipartisan leadership in the fight against cancer. Through ROCR, Congress can build a future where radiation oncology reimbursement is driven by patient needs, not by the number of treatments provided,” said Jeff Michalski, MD, MBA, FASTRO, Chair of the American Society for Radiation Oncology (ASTRO) Board of Directors. “This bill represents a pivotal turn in how Medicare values radiation oncology care. By passing it, Congress would ensure that high quality treatment remains accessible for all patients, especially those in rural and underserved communities.”

One of ROCR’s most impactful components is an evidence-based approach to reducing disparities in cancer treatment. Under ROCR’s Health Equity and Achievement in Radiation Therapy (HEART) initiative, centers would receive funds to support patients who face transportation barriers accessing and completing their radiation treatments. HEART is based on a model from a National Cancer Institute-funded study that reduced disparities and increased survival for a community in North Carolina; ROCR expands this evidence-based initiative nationwide.

“It’s tragic when transportation obstacles get in the way of curing cancer. Our rural and underserved patients deserve better access, and the HEART initiative will ensure that many more Americans can benefit from radiation therapy,” said Dr. Michalski.

ROCR would also end decade-long declines in Medicare payments for radiation therapy, which is prescribed to more than a million Americans with cancer each year. Despite the outsized value that radiation oncology delivers for patients and Medicare, reimbursements for radiation therapy under the Medicare Physician Fee Schedule have been cut by 23% over the past decade, more than nearly any other medical specialty.

ROCR builds off the strengths of the indefinitely-delayed Medicare-proposed Radiation Oncology Alternative Payment Model – specifically the use of episode-based payments – and seeks to address its shortcomings, including outsized payment cuts, burdensome quality requirements and the absence of mechanisms to reduce disparities.

Key features of ROCR include:

•           Leveraging episode-based payments to align financial incentives with scientifically proven outcomes.

•           Supporting shorter treatments for certain cancers, allowing patients more time to work and spend time with loved ones.

•           Reducing disparities that create barriers for patients from rural and underserved communities to access and complete treatments.

•           Implementing a systematic approach to improve quality and protect patient safety through practice accreditation.

•           Unifying payments across settings based on hospital technical payments.

•           Generating Medicare savings of approximately $200 million over 10 years.

Read the bill here.